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BACKGROUND: The uveitis–glaucoma–hyphema (UGH) syndrome was first described in 1978 as a complication of anterior chamber polymethyl methacrylate intraocular lenses implantation. Introduction into practice of foldable intraocular lenses with intracapsular fixation has reduced the incidence of UGH. However, this complication still occurs today, especially with extracapsular intraocular lens fixation. AIM: The aim of this study is to describe “uveitis–glaucoma–hyphema” syndrome pathogenesis, clinical features, and diagnosis. MATERIAL AND METHODS: A retrospective analysis of medical data for 2017–2021 identified 100 patients (101 eyes) diagnosed with UGH syndrome, they made up the study group. Complaints, medical history, biomicroscopy, visual acuity and intraocular pressure were assessed. 37 patients underwent anterior segment ultrasound biomicroscopy using the Accutome UBM Plus (USA). RESULTS: The occurrence of UGH syndrome is at least 0.19%. The leading UGH syndrome risk factor was intraocular lens material. In 49% of cases these were AcrySof hydrophobic intraocular lenses. The second UGH risk factor was extracapsular (mixed and sulcus) intraocular lens fixation, occurring, according to ultrasound biomicroscopy, in 54 and 19% of cases, respectively. The most significant diagnostic UGH sign was hyphema (93%). Ocular hypertension was detected in 66%, and uveitis in 57% of cases. CONCLUSIONS: The main UGH syndrome manifestations are hyphema and iris transillumination after phacoemulsification complicated by posterior capsule rupture with extracapsular hydrophobic intraocular lens fixation. The most informative instrumental method to assess intraocular lens position is ultrasound biomicroscopy.
BACKGROUND: The uveitis–glaucoma–hyphema (UGH) syndrome was first described in 1978 as a complication of anterior chamber polymethyl methacrylate intraocular lenses implantation. Introduction into practice of foldable intraocular lenses with intracapsular fixation has reduced the incidence of UGH. However, this complication still occurs today, especially with extracapsular intraocular lens fixation. AIM: The aim of this study is to describe “uveitis–glaucoma–hyphema” syndrome pathogenesis, clinical features, and diagnosis. MATERIAL AND METHODS: A retrospective analysis of medical data for 2017–2021 identified 100 patients (101 eyes) diagnosed with UGH syndrome, they made up the study group. Complaints, medical history, biomicroscopy, visual acuity and intraocular pressure were assessed. 37 patients underwent anterior segment ultrasound biomicroscopy using the Accutome UBM Plus (USA). RESULTS: The occurrence of UGH syndrome is at least 0.19%. The leading UGH syndrome risk factor was intraocular lens material. In 49% of cases these were AcrySof hydrophobic intraocular lenses. The second UGH risk factor was extracapsular (mixed and sulcus) intraocular lens fixation, occurring, according to ultrasound biomicroscopy, in 54 and 19% of cases, respectively. The most significant diagnostic UGH sign was hyphema (93%). Ocular hypertension was detected in 66%, and uveitis in 57% of cases. CONCLUSIONS: The main UGH syndrome manifestations are hyphema and iris transillumination after phacoemulsification complicated by posterior capsule rupture with extracapsular hydrophobic intraocular lens fixation. The most informative instrumental method to assess intraocular lens position is ultrasound biomicroscopy.
Viscoelastic substances (VS) are an integral part of modern ophthalmic surgery. This review briefly highlights the main characteristics, classification of VS, their areas of application, and their effect on platelet aggregation. In the scientific literature, little attention has been paid to the use of VE in surgery of the posterior segment of the eye; therefore, the main goal of this review was a detailed presentation of the possibilities and prospects for the use of VS in various pathologies of the retina and vitreous body. In vitreoretinal surgery (VRS), cohesive VS are more widely used due to the ease of their removal from the vitreal cavity compared to dispersed VS. The main disadvantage of using VS is their effect on ophthalmotonus, which requires careful monitoring of the completeness of the removal of VEs from the eye at the end of the operation. The review deals with the use of VE in macular pathology for the purpose of mechanical and chemical protection of the retina when working with a luxed lens or introducing dyes that have a toxic effect on the retinal tissue. In macular hole surgery, VS can be used to stabilize the ILM flap, as well as to prevent subretinal migration of retinal dye. The possibilities of using VS in VRS in pediatric practice for the purpose of viscodelamination of retrolental strictures during vitrectomy in eyes with traction vitreoretinopathy and preservation of the native lens are described. Special attention is paid to the use of VS in the most complex surgical pathology requiring VRS — proliferative diabetic retinopathy. Their advantages have been demonstrated in terms of reducing the time of intervention, which, in turn, reduces the risk of intraoperative complications. The use of the viscodissection technique makes it possible to increase the safety of surgery during the most traumatic stages of the operation: separation of the posterior hyaloid membrane and, in particular, when working with proliferative fibrovascular membranes. The advent of the VS staining method opened up new prospects for the use of viscodissection and viscodelamination techniques.
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